Hypospadias is a congenital condition in which the opening of the urethra (the tube through which urine passes) is located on the underside of the penis instead of at the tip. This condition can affect the normal function and appearance of the penis, and may cause problems with urination, sexual function, and self-esteem later in life. Dr. Pruthvi Raj Honnaiah specializes in the comprehensive evaluation, diagnosis, and surgical correction of hypospadias, ensuring optimal functional and cosmetic outcomes for your child.

Types of Hypospadias

Hypospadias is classified based on the location of the urethral opening:

• Distal Hypospadias: Opening is near the head of the penis (most common type).
• Midshaft Hypospadias: Opening is along the shaft of the penis.
• Proximal Hypospadias: Opening is near the base of the penis or in the scrotum (more severe).

Symptoms and Signs

Hypospadias is typically identified at birth during routine examination. Key signs include:

• Abnormal Urinary Stream: Urine may spray in different directions.
• Urethral Opening Location: The opening is on the underside of the penis.
• Curved Penis (Chordee): In some cases, the penis may curve downward.
• Incomplete Foreskin: The foreskin may form a hood-like appearance.

Diagnostic Evaluation

Evaluation of hypospadias involves:

• Clinical Examination: A thorough examination of the penis, scrotum, and perineum to assess the location of the urethral opening, curvature, and foreskin development.
• Genital Examination: Assessment for associated conditions such as undescended testis or inguinal hernia.
• Imaging (if needed): In cases of severe hypospadias, ultrasound may be recommended to assess internal genital structures.
• Hormonal or Genetic Testing (in rare cases): For severe hypospadias, testing may be required to rule out disorders of sexual development (DSD).

Surgical Correction (Hypospadias Repair)

Surgery is the recommended treatment for correcting hypospadias. The goal is to create a straight penis with a urethral opening at the tip, ensuring proper urinary and sexual function.

• Timing: Surgery is typically performed between 6 to 18 months of age for optimal healing and development.
• Surgical Procedure: The surgery involves:
  • Straightening any curvature (Chordee correction).
  • Creating a new urethral tube (Urethroplasty) to reposition the opening at the tip.
  • Reconstructing the foreskin (if desired) or circumcision.
• Types of Surgical Techniques: Techniques vary depending on the severity and location of the opening and may include:
  • TIP Repair (Tubularized Incised Plate): Common for distal hypospadias.
  • Two-Stage Repair: For severe or proximal hypospadias.
  • Preputial Flap or Graft: Using the foreskin to reconstruct the urethra.
• Post-Surgery Care: Includes catheter care, pain management, and follow-up evaluations.

Outcomes and Follow-Up

With expert surgical care, most children achieve excellent cosmetic and functional outcomes. Follow-up care ensures proper healing, urinary function, and early detection of rare complications such as fistula formation or urethral stricture.

Why Choose Dr. Pruthvi Raj for Hypospadias Surgery?

Dr. Pruthvi Raj Honnaiah brings extensive expertise in the evaluation and surgical repair of hypospadias. His patient-centric approach, use of advanced surgical techniques, and focus on achieving both functional and cosmetic success ensure the best possible outcomes for your child.